DAELENE SUEANN TIBBITTS

MOUNTAIN HOME, ID
NPI1891247912
Former NameDAELENE SUEANN STRAW
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: ID  PTA-4637)
Enumeration Date2016-10-25
Last Update Date2016-10-25
Business Address
Mrs. DAELENE SUEANN TIBBITTS PTA
1665 E 5TH N
MOUNTAIN HOME, ID 83647
Phone number: 208-598-5047
Mailing Address
Mrs. DAELENE SUEANN TIBBITTS PTA
1665 E 5TH N
MOUNTAIN HOME, ID 83647
Phone number: 208-598-5047
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